Healthcare Provider Details

I. General information

NPI: 1770587644
Provider Name (Legal Business Name): MEDICAL CENTER PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/09/2005
Last Update Date: 09/02/2022
Certification Date: 09/02/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

805 S LONG DR
ROCKINGHAM NC
28379-4317
US

IV. Provider business mailing address

805 S LONG DR
ROCKINGHAM NC
28379-4317
US

V. Phone/Fax

Practice location:
  • Phone: 910-997-4471
  • Fax: 910-997-4951
Mailing address:
  • Phone: 910-997-4471
  • Fax: 910-997-4951

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number03460
License Number StateNC

VIII. Authorized Official

Name: GREGORY A MARKS
Title or Position: PRESIDENT
Credential: RPH
Phone: 910-997-4471